An Electrocardiogram Records the electrical impulses associated
with cardiac contraction and relaxation.
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ECG Uses: Identifies rhythm disturbances, conduction
abnormalities and electrolyte imbalances. Contributes information
about the size of the heart chambers and the relative position of
the heart in the chest. Documents the diagnosis and progression of
myocardial infarction (MI). Monitors recovery from MI. Monitors
drug effects. Evaluates the function of artificial pacemakers.
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Electrocardiography (ECG) Technician Performs the EKG (ECG) May
work in hospitals, medical offices, cardiac rehab centers or other
health care facilities.
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Educational Requirements: On the job training from 8 to 16
weeks One-year certification programs available
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Responsibilities: Provide client instructions. Perform a safe
and accurate tracing of the EKG. Ensure that the results are placed
in the clients chart. Maintain the EKG equipment.
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Patient Preparation: The most important factor is to make sure
the patient is relaxed. (informed and comfortable) The patient
should be lying comfortably on a bed, stretcher or table wide
enough to support his arms and legs. Remove shoes, loosen clothing
and keep the patient warm.
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Recording position: Most comfortable to work from the left side
of the patient, where you are closest to the patients heart. To
prevent artifacts, always keep the power cord pointing away from
the patient and never run the cord under the bed.
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Prepping the Patient: Since skin is a poor conductor of
electricity, it may be necessary to prep the skin. If the patient
is extremely hairy, you may need to shave small areas to ensure
good adhesion. If the skin is oily, use and alcohol prep and let
dry. Always apply electrodes before entering patient info into the
machine to allow electrolyte material to interact with the
skin.
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Electrodes:
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Attaching the Leads to the Electrodes Most lead wires are color
coded to ensure the proper lead wire is connected to the proper
electrode. Make sure the lead cables follow the patient contour and
lay flat against the patients body. Avoid large loops.
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Limb Lead Placement:
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Electrodes:
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ECG Paper
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Cleaning and storing the ECG Clean the lead wires and machine.
(Usually wiped down with a cloth moistened with disinfectant.)
Throw away disposable electrodes in proper containers. Drape the
lead wires of the machine in an orderly fashion. Return the machine
to the designated storage location.
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The ECG Complex Three words describe the activity of the heart:
1. Polarized 2. Depolarization 3. Repolarization
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Polarized-the heart at rest. No impulse, no stimulation, no
contraction and no measurable activity. Depolarization-activity of
the heart during the impulse that causes contraction, but not the
contraction itself. (can be measured by the ECG) Repolarization-the
electrical recovery of the heart as the cells recharge themselves.
(can be measured by the ECG)
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P Wave The first wave to appear on the ECG. The impulse that
causes the atria to contract. (Depolarization)
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PR Interval The lapse of time between the beginning of atrial
contraction and the beginning of ventricular contraction. (The
beginning of the P wave to the onset of the QRS complex.)
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QRS Complex Ventricular depolarization, or the journey of the
electrical impulse from the AV node through the Purkinje
network.
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QRS Interval The period of ventricular depolarization
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ST Segment The transition period between the conclusion of
ventricular contraction and the beginning of electrical recovery
(repolarization).
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T Wave Represents repolarization of the ventricle, as the cells
recharge themselves in preparation of another impulse.
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Normal Sinus Rhythm Rhythm: Regular Heart Rate: 60-100 beats
per minute
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Sinus Tachycardia The heart beats faster than normal. Rhythm:
Regular Rate: 100-150 beats per minute Cause: Excitement, exercise,
pain, fever, hypotension and other causes. Treatment: treat the
underlying cause.
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Sinus Bradycardia The heart rate is slower than normal. Rhythm:
Regular Rate: 40-59 beats per minute Cause: medications,
hypothermia, increased intracranial pressure, inferior MI, and
other causes. Treatment: give Atropine IV.
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Sinus Arrhythmia Normal rhythm of the heart is absent. Rhythm:
Irregular Rate: 60-100 Cause: Normal phenomenon commonly associated
with the phases of respiration. Treatment: None